The honeymoon phase consists of strong community cohesion, hope, and teamwork. During this phase, which can vary in length of time depending on individual variability of emotional resilience, we saw a unity in Puerto Ricans that we had not seen for a long time. Neighbors who never spoke to one another worked together. Organizations that competed with each other or never collaborated became partners. Many of those who rejected the Puerto Ricans who had left the island as having abandoned it for a better life were now willing to embrace them and praised their efforts to help from abroad. Some families that were strained and divided reconciled and reunited, although many became separated geographically.
This was a temporary antidote to facilitate the recovery from the catastrophe that Maria caused. It also led many to confront governmental incompetence, to relieve the wounds of immigration, to build a new sense of patriotism, and to courageously address the consequences of a fiscal austerity plan that affects most Puerto Ricans to this day. However, as with most honeymoon phases, this period did not last long, since it requires a great deal of endurance and stamina to rebuild, recover, and grieve at the same time, while consistently maintaining hope, unity, and positivity.
Eventually, most humans go through different degrees of emotional burnout, despair, negativity, and irritability after enduring such an intense level of trauma. This was particularly true for first responders; for those who lost relatives, became ill, or lost their homes; and for community leaders who continually supported those most affected and sometimes acquired roles for which they were not trained, in public health initiatives and basic disaster response endeavors that are usually led by government agencies. These community leaders often experienced significant trauma from their own losses and limitations, as we heard during the 11 workshops that our CrearConSalud team conducted with non-profit organizations, churches, and other community groups.
Disaster survivors tend to enter the stage of disillusionment 3 to 6 months after the impact. Puerto Ricans were hit hard by such a letdown as we realized that community cohesion and individual resilience are not enough. During this phase, people often go through a steep decline into emotional lows and then their optimism starts to rise, but more slowly than before.
Many become further disillusioned when they experience “trigger events,” so-called re-traumatization. In Puerto Rico, trigger events occurred almost daily, and some recur to this day. Initially, the island endured chronic absence of electricity and water for many months, and Puerto Ricans still experience intermittent interruptions in these vital services. There were also periods of severe rain shortly after the hurricane that caused more floods, more road closures, delays in re-establishing communication, and additional lost days of work and school for many. There was poor telecommunication through phones and Internet access for months. Several public health crises, such as a leptospirosis outbreak and increased suicide rates, emerged.
The compounded socioeconomic consequences of economic hardship and lost jobs and homes still weigh heavily on the population. The limitations in public health care and socioeconomic conditions highlighted by the hurricane are worsening because of corruption and austerity measures implemented by a fiscal control board assigned by Congress to find ways for Puerto Rico to pay for a public debt that was never fully audited. These measures have led to school closures, increased sales taxes, cuts in funds for the island’s public university, and plans to implement reforms that will limit access to health care—all of which make it even more difficult for Puerto Ricans to overcome the consequences of the disaster.
Amidst this austerity plan, I have witnessed how some Puerto Ricans are slowly regaining a sense of hope, replenishing energy, and building stronger emotional stamina. They are moving beyond the disillusionment phase and entering the long-term phase of reconstruction. This phase usually starts around the anniversary of a disaster and involves a long process of coming to terms with what happened, adapting to how things are after the disaster, reinventing within the limitations of long-term consequences, coping with setbacks, and continuing to readjust as needed.
Transformational resilience >>
Dr Cabán-Alemán reports no conflicts of interest concerning the subject matter of this article.
1. Hall TM, Kossin JP. Hurricane stalling along the North American coast and implications for rainfall. Climate Atmospheric Science. 2019;2:17.
2. Compton MT, Shim RS, eds. The Social Determinants of Mental Health. Arlington, VA: American Psychiatric Publishing; 2015.
3. DeWolfe DJ. Training Manual for Mental Health and Human Service Workers in Major Disasters. 2nd ed. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. 2000. HHS Publication No. ADM 90-5382000.
4. Doppelt B. From Me to We: The Five Transformational Commitments Required to Rescue the Planet, Your Organization, and Your Life. Abingdon, UK: Routledge; 2017.